PREVENTION OF POST-RESTORATION PAIN BY PROCESSING CARIOUS CAVITIES WITH WETTING AGENT
Abstract. Aesthetic restoration plays an indispensable part in the treatment of dental caries. Optimal materials for restorations are photopolymer composites of different groups. It is connected both with functional properties of materials, their usability, possibility of full recovery of the anatomical shape of a tooth, and with the grown of aesthetic requirements of the patients. Preparation of dental tissues for the adhesive system occupies a special place. Their condition determines the penetration depth of an adhesive and the probability of stress appearance in dentinal tubules, that subsequently leads to the development of post-restoration pain. Carrying out the steps for using a particular adhesive system dentists determine the dentin moisture by visual indicators, that is subjective, which in turn is one of the reasons of incorrect assessment of the dental tissues and may cause treatment failure and development of post-filling pain.
Demineralized dentine matrix after etching is easily broken when it is air dried. In the process of air drying, the moisture filling intertubular space is lost due to evaporation, which leads to the collapse of the collagen fibers. This is manifested in the appearance of postoperative sensitivity and increased reaction to acid, thermal and mechanical stimuli. To preserve the physiological state of the dentin collagen fibers it is advisable to apply additional moisturizing agents in dentin processing during preparation of carious cavities for restoration.
A study of clinical efficiency of the wetting agent "Dent Light-aqua" to prevent the development of post restoration pain was conducted.
The study covered 161 restoration works in 84 patients of different age. All patients were divided into 4 groups depending on the restorative material and the use of the wetting agent "Dent Light-aqua": Group 1 - restoration with a composite "DentLight"; Group 2 - restoration with a composite "DentLight" in combination with the dentin treatment by "Dent Light-aqua"; group 3 - restoration with “Filtek Supreme XT”; group 4 – restoration with “Filtek Supreme XT” in combination with the dentin treatment "Dent Light-aqua".
Evaluation of restorations was carried out the next day and 3 days after the works in accordance with the verbal rating scale of pain, which allows to estimate the intensity of pain by qualitative verbal assessment.
As a result of the clinical studies and comparative analysis of the data obtained after 1 day it was ascertained that in groups 1 and 3, the number of patients complain about post restoration pain was significantly higher than in the second and fourth study groups. In addition, it was noted that the complaints of the second and fourth groups match the characteristics of the low level of pain, and there were cases of complaints about "moderate pain" and "strong pain" respectively in the first and third groups.
After 3 days there were no complaints in the second and fourth groups, while in the first and third groups post-restoration pain occurred.
The obtained results showed that the use of the wetting agent "Dent Light-aqua" makes it possible to prevent the occurrence of post-restoration pain in the treatment of average caries.
A promising direction is to explore the possibility of using wetting agents in the treatment of other forms of caries with different process activity, as well as to study morphological features of the material and tooth dentin interaction.
2. Борисенко А.В. Ошибки и осложнения, возникающие при использовании композиционных материалов / А.В. Борисенко // Современная стоматология. - 1999. - № 2. - С. 8 - 11.
3. Виноградова Т.Ф. Новые материалы и технологии в терапевтической стоматологии / Т.Ф. Виноградова, С. Уголева // Новое в стоматологии. - 1996. - № 3. – Спец. выпуск. - С. 3-63.
4. Реакция микрососудов пульпы зуба на использование современных нанокомпозитных материалов при лечении кариеса/ Е.К. Кречина, В.В. Маслова, А.В. Рассадина [и др.]// Стоматология. - 2009. - № 2. - C. 27-28.
5. Семикозов О.В. Клинический взгляд на самопротравливающие адгезивы / О.В. Семикозов // Проблемы стоматологии. - 2010. - № 4. - С. 12-16.
6. Лобовкина Л.А. Как правильно выбрать и применять адгезивные системы при работе с реставрационными материалами / Л.А. Лобовкина, А.М. Романов // Стоматолог-практик. - 2007. - № 4. - С. 4-6.
7. Рыбникова Е.П. Клинические аспекты современного подхода к лечению кариеса зубов. Вопросы и ответы / Е.П. Рыбникова // Клиническая стоматология. - 2008. - № 1. - С.14-15.